A large proportion of Hennepin County opioid-related deaths in 2015 and 2016 occurred after a jail stay, according to a collaborative study by Hennepin Healthcare and Hennepin County. The finding, reached after an analysis of death and jail records, confirms county officials’ suspicions and suggest opportunities for overdose prevention.

The study found that more than one-third of opioid deaths in Hennepin County (71/252) occurred within one year of release from custody. Almost a quarter of those occurred within two weeks of release, and more than half were within 90 days. Among people who died from an overdose after a jail stay, 81 percent were incarcerated for at least 24 hours.

Study offers opportunities for change

The findings point to the need for a shift in how officials in corrections, health and human services offer recovery services, said Dr. Tyler Winkelman, a physician-researcher at Hennepin Healthcare.

“Most people with an opioid use disorder will spend time in the criminal justice system,” Winkelman said. “This report shows that correctional facilities can and should play a critical role in the public health response to the opioid epidemic. Expanding treatment options for this population could substantially lower opioid deaths in Hennepin County.”

Currently in Hennepin County, embedded social workers connect people with behavioral and chemical health resources for follow-up after release. However, diagnosing opioid use disorder and beginning medical treatment while in custody could have positive outcomes for people, reducing the number of deaths and the traumatic and expensive overdose-hospitalization-jail cycle that usually precedes them.

Previous research suggests that for every overdose death, there are more than 20 nonfatal overdoses.

Hennepin County is applying for grant funding available through recent federal legislation, which in combination with county funding, will strengthen current practices:

Include substance use disorder screening in jail health intake

Create a system to help get people started with treatment, or to support those who already are using medications like naltrexone, buprenorphine or methadone to control their disorder

Strengthen connections to community treatment providers

“This report highlights exactly how local government should be operating, using data available to us to inform decisions and interventions that make sense in our community,” said Julie Bauch, the county’s opioid response coordinator. “The reality is staggering. But this data presents a real opportunity for us to make targeted and impactful change that improves the lives of our residents and improves the systems that create better long-term sustainable outcomes.”

Rhode Island offers a model

Other agencies’ work has shown that intervention for opioid use disorders is effective. Rhode Island implemented treatment for opioid use disorders across every jail and prison in the state. A year after they implemented the program, overdose deaths following release decreased by 60 percent. Overdose deaths statewide decreased by 12 percent.

In Minnesota, treatment for opioid use disorder is rarely available during incarceration or immediately after release.

“We can save lives by administering medical treatment to people who are struggling with an opioid use disorder before they are released from detention facilities,” said County Board Chair Marion Greene. “I am extremely pleased that Sheriff Hutchinson’s team and Community Corrections staff are moving forward to implement recommendations made in the report.”

Other findings:

Across the state, 775 people died during the same period from causes related to opioids, an increase of 26 percent from 2011-2012.

Hennepin County residents accounted for 33 percent of those deaths.

African American and Native American people were disproportionately represented among the dead.

Residents of suburban Hennepin County accounted for nearly half of the deaths.